Stem cells from bone marrow

[Birgitta-A]

Hi All,
Now one researcher advice stem cells from bone marrow for STC due to less risk for GVHD. Remember that new drugs that reduce GVHD are in the pipeline.
http://listserv.icors.org/scripts/wa...com&P= 210330
Kind regards
Birgitta-A

[Marlene]

The link required a password. So if you cannot access it, check this one out. I think it's the same source. I've seen the original study earlier this year and the one thing that stood out is that stem cells from the blood tend to graft better than those from the bone marrow. But as we all have seen, GVHD can be very serious and in the long run, it may be better to go with bone marrow cells.

http://www.sciencedaily.com/releases...1017180200.htm

[tytd]

Hello Marlene and Birgitta, Thanks for keeping us up to date. The original study abstract and editorial from Dr. Appelbaum are available at www.nejm.org which is in the most current issue of The New England Journal of Medicine. One comment in the editorial which might apply to potential older BMT candidates who would get a reduced intensity regimen is "instead of being the default choice for most unrelated donor transplants, mobilized peripheral-blood stem cells should be used in only the minority of patients for whom the benefits outweigh the risks. These include patients in need of rapid engraftment, such as those with life-threatening infections, and patients at high risk for graft rejection, including those undergoing reduced intensity conditioning without prior exposure to intensive chemotherapy." This study looked at leukemia patients as well as MDS patients and only at unrelated donors transplants. I guess the recommendation for sibling donors would still be peripheral stem cells?? Can any of our transplant survivors out there tell us whether they received stem cells or bone marrow? Thanks tytd

[Marlene]

Some good points tytd. It would be good to know the stats on both mud and sibling donors.

Hopkin and few other centers are starting to use high dose cytoxan after the transplant to prevent the GVHD and are having some good results.

[mausmish]

In addition to the high dose Cytoxan, Hopkins also uses marrow to help prevent/lessen GvHD. Mine was a full myeloablative, MUD transplant and I engrafted well within three weeks.